Provider Demographics
NPI:1720795156
Name:TROUT, DEBORAH MARIA (BSL)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MARIA
Last Name:TROUT
Suffix:
Gender:F
Credentials:BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 INDIAN FIELD LN
Mailing Address - Street 2:
Mailing Address - City:TELFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18969-2457
Mailing Address - Country:US
Mailing Address - Phone:267-203-1500
Mailing Address - Fax:
Practice Address - Street 1:420 COWPATH RD
Practice Address - Street 2:
Practice Address - City:SOUDERTON
Practice Address - State:PA
Practice Address - Zip Code:18964-2036
Practice Address - Country:US
Practice Address - Phone:267-203-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH003025174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist